Definition

What is pelvic organ prolapse ?

Pelvic organ prolapse occurs when a pelvic organ-such as your bladder-drops (prolapses) from its normal place in your lower belly and pushes against the walls of your vagina. This can happen when the muscles that hold your pelvic organs in place get weak or stretched from childbirth or surgery.

Many women will have some kind of pelvic organ prolapse. It can be uncomfortable or painful. But it isn’t usually a big health problem. It doesn’t always get worse. And in some women, it can get better with time.

More than one pelvic organ can prolapse at the same time. Organs that can be involved when you have pelvic prolapse include the:

Bladder. This is the most common kind of pelvic organ prolapse.

Urethra

Uterus

Vagina

Small bowel

Rectum

Pelvic organ prolapse is most often linked to strain during childbirth. Normally your pelvic organs are kept in place by the muscles and tissues in your lower belly. During childbirth these muscles can get weak or stretched. If they don’t recover, they can’t support your pelvic organs.

How common is pelvic organ prolapse?

Symptoms

What are the symptoms of pelvic organ prolapse ?

Feeling pressure from pelvic organs pressing against the vaginal wall. This is the most common symptom.

Feeling very full in your lower belly.

Feeling as if something is falling out of your vagina.

Feeling a pull or stretch in your groin area or pain in your lower back.

Releasing urine without meaning to (incontinence), or needing to urinate a lot.

Having pain in your vagina during sex.

Having problems with your bowels, such as constipation.

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.

Causes

What causes pelvic organ prolapse ?

Pelvic organ prolapse is usually caused by damage to the tissues (muscles, ligaments, and connective tissue) that support the pelvic organs. Damage or stretching of these tissues allows the organs to move out of their normal positions. This causes them to press against (and sometimes move) the inside walls of the vagina.

Having a baby makes it more likely that you will have pelvic organ prolapse later. Vaginal childbirth has been strongly linked to weakened and stretched support structures in the pelvic area. This loss of support is the biggest cause of pelvic organ prolapse. Having a cesarean section, on the other hand, seems to be less strongly linked to pelvic organ prolapse.

Another cause of reduced support in the pelvis is lower levels of the hormone estrogen. Estrogen levels are lower during and after menopause. The lower levels of estrogen in the body mean less collagen, a protein that helps the pelvic connective tissues stretch and return to their normal positions.

Pelvic organ prolapse can also occur after surgical removal of the uterus (hysterectomy) for another health problem, such as endometriosis. Removal of the uterus can sometimes leave the other organs in the pelvic area with less support.

Smoking and/or lung disorders, which are often causes of chronic coughing.

Conditions affecting the spinal cord, such as muscular dystrophy, multiple sclerosis, and spinal cord injury, that cause paralysis of the muscles of the pelvic floor.

Risk factors

What increases my risk for pelvic organ prolapse?

There are many risk factors for pelvic organ prolapse, such as:

Have surgery to remove your uterus (hysterectomy). Removing the uterus can sometimes leave other organs in the pelvis with less support.

After childbirth

Being very overweight (obesity).

A long-lasting cough.

Frequent constipation.

Pelvic organ tumors.

Older women are more likely to have pelvic organ prolapse. It also tends to run in families.

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How ispelvic organ prolapse diagnosed?

Your doctor will ask questions about your symptoms and about any pregnancies or health problems. Your doctor will also do a physical exam, which will include a pelvic exam.

Decisions about your treatment will be based on which pelvic organs have prolapsed and how bad your symptoms are. Tests may be done to find out the nature of a prolapse, particularly if it is causing problems with bladder or bowel function. These tests include:

Cystoscopy, a test that allows your doctor to look at the interior lining of the bladder and the urethra.

Intravenous pyelogram (IVP), an X-ray test that can show the size, shape, and position of the kidneys, bladder, ureters, and urethra.

Doctors use a classification system to determine the level of an organ’s prolapse. Identifying the exact level of prolapse helps guide decisions about which treatments are most likely to offer long-term success. One standard classification uses “stages” of prolapse and is based on how close the lowest part of the organ is to the opening of your vagina (the hymen).

How is pelvic organ prolapse treated?

If your symptoms are mild, you may be able to do things at home to help yourself feel better. You can relieve many of your symptoms by adopting new, healthy habits. Try special exercises (called Kegels) that make your pelvic muscles stronger. Reach and stay at a healthy weight. Avoid lifting heavy things that put stress on your pelvic muscles.

If you still have symptoms, your doctor may have you fitted with a device called a pessary camera.gif to help with the pain and pressure of pelvic organ prolapse. It is a removable device that you put in your vagina. It helps hold the pelvic organs in place. But if you have a severe prolapse, you may have trouble keeping a pessary in place.

Surgery is another treatment option for serious symptoms of pelvic organ prolapse. But you may want to delay having surgery if you plan to have children. The strain of childbirth could cause your prolapse to come back.

Lifestyle changes & Home remedies

What are some lifestyle changes or home remedies that can help me manage pelvic organ prolapse?

The following lifestyles and home remedies might help you cope with pelvic organ prolapse :

Do Kegel exercises every day to strengthen the muscles and ligaments of the pelvis.

Prevent or correct constipation. The straining caused by constipation increases pressure from the bowel on the vaginal wall and weakens and damages the connective tissue and muscles in the pelvis.

Try gentle exercise. Take a short walk each day. Gradually increase your walking time until you are walking for at least 20 minutes each day.

Make sure you drink enough fluids.

Eat plenty of high-fiber foods such as whole grains, fruits, and vegetables every day. Have a bran muffin or bran cereal for breakfast, and try eating a piece of fruit for an afternoon snack. Try to eat about 20 g of fiber every day.

Schedule time each day for a bowel movement-after breakfast, for example. Having a daily routine may help. Take your time.

If you continue to be constipated, try taking processed or synthetic fiber (such as Citrucel, Metamucil, or Perdiem) each day.

If your stools are very hard, try taking a stool softener, such as Colace, to prevent straining.